Provider Demographics
NPI:1508605346
Name:SCHUSTER, KELLY (BCBA)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2938
Mailing Address - Country:US
Mailing Address - Phone:864-650-0234
Mailing Address - Fax:
Practice Address - Street 1:14 PROGRESS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5703
Practice Address - Country:US
Practice Address - Phone:864-590-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst